The service faced challenges such as rising demand, suboptimal use of GP capacity and dissatisfaction with appointment access. In response, Lime Tree implemented a modern general practice model to better match capacity to people’s needs, improve access and enhance staff wellbeing. The system includes an online consultation platform to triage incoming requests, aiming to reduce the 8am rush and optimise resource allocation, including the use of Additional Roles Reimbursement Scheme (ARRS) staff.

Key learnings

• The introduction of an online consultation system enabled the practice to better manage incoming requests by allowing for real-time triaging based on clinical urgency. This allowed quicker responses and ensured that appointments were reserved for those who needed them most.
• By creating a care navigation team that includes a senior GP and 2 GP assistants, the surgery was able to prioritise requests, enhance patient navigation and triage, and make better use of their multidisciplinary teams, including ARRS staff.
• The shift towards online consultations and the ability to complete requests via multiple channels (online, phone and in-person) improved access to services.
• Reception staff experienced a 45% decrease in incoming calls, leading to improved wellbeing and less pressure throughout the day.
• The practice emphasised person-centred care by prioritising clinical needs, empowering people to take part in self-care and reducing unnecessary GP appointments. This approach ensured that GP time was used for more complex cases.

Impact

Lime Tree Surgery reports:

• avoidable GP appointments reduced to 5% (from 25%), with improved use of the broader multidisciplinary team
• more than 90% of patient requests dealt with on the same day
• 100% of clinically urgent presentations dealt with on the same day
• call waiting times of more than 10 minutes reduced from 38% to 3%, and unanswered call rates reduced from 14% to 6% since implementing online access
• 92% of patients satisfied or very satisfied with practice response times, and 93% of patients satisfied or very satisfied with treatment and care received (based on 497 survey responses)
• 97% reduction in verbal complaints about access, and written complaints about access reduced from 7 in the quarter before implementation to 0 in the 12 months after implementing the new appointment system

Further evidence

Studies underscore the importance of digital solutions, workforce optimisation and care navigation in improving primary care.

• Retrospective, repeated cross-sectional study on primary care access changes
• Cross-sectional analysis of online consultation systems and patient experience

Publication reference: PRN01756_ii